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Amputee Coalition of America Establishes Action Plan for People With Limb Loss
(excerpt from O & P Business News, June 1, 2005...)

Three States With Mandated Prosthetic Coverage
   
Currently, three states already have statutes mandating prosthetic coverage: Colorado, Maine, and New Hampshire.

    Colorado was the first  state to pass such legislation.  Colorado's statute requires health insurers in that state to provide coverage for prosthetic devices "that equal those benefits" provided by Medicare.  The statute also expressly mandates coverage for repairs and replacements, unless they are necessitated by "misuse or loss."

    Like Colorado, Maine's statute requires health insurers in that state to provide coverage for repairs and replacements "if repair or replacement is deemed appropriate by the enrollee's provider."  Unlike Colorado, Maine's statute does not require coverage for "a prosthetic device that contains a microprocessor or that is designed exclusively for athletic purposes."

    The New Hampshire statue provides that "an insurer shall not impose any annual or lifetime dollar maximum on coverage for all prosthetic devices other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy."  The statue does not specifically address repairs or replacements.

Five States Pending Legislation
   
In addition, five states have pending prosthetic legislation: New York, Connecticut, Massachusetts, New Jersey, and Washington.

For more information contact Paula Rogerson, MSOP (Massachusetts Society of Orthotists and Prosthetists) President.

 

Home ] About Our Company ] About Ingrid Frank, C.P. ] Prosthetics ] Orthotics ] Mastectomy Products ] Compression Garments ] Other Services ] Directions ] Links ] Contact Information ] [ Pending Legislation ] Privacy/Patient Policies ]





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